Koppitz' Bender scoring system and brain injury in children

Neuropsychological assessment of brain damage: discriminative validity of the McCarron-Dial System

The purpose of this study was to investigate the discriminative validity of the McCarron-Dial System (MDS) in neuropsychological assessment. Multiple discriminant analysis results indicate that 92.6% of the brain-damaged and non-brain-damaged groups, and 69.6% of the right, left and diffused brain-damaged subgroups were correctly classified using the abbreviated version of the MDS. The results tentatively support the discriminative ability of the MDS for neurobehavioural diagnosis. Since the MDS has a long tradition in vocational rehabilitation and established strengths in predicting vocational and community adjustment outcomes, it may be potentially useful for both vocational and clinical neuropsychological assessment.

Interrater reliability of the Koppitz Developmental Scoring method in the clinical evaluation of the single case

Using the Koppitz method, Bender-Gestalt protocols of three patients (8-12 yr.), representing three commonly occurring disorders, and of one normal child were evaluated by 12 raters of varying experience with this system. Raters were asked to make provisional diagnoses based on Bender protocols alone, and these were compared with actual clinical diagnoses. Despite significant interrater reliability of Koppitz Total Developmental Scores and emotional indices, no significant agreement was found in subscores or in diagnoses made, although the effect of raters' experience was noted. Results suggest that the type of dysfunction present is a factor in raters' reliability. Results are seen, however, to support the potential of the Bender-Gestalt for use in relatively subtle diagnosis of children and highlight the differentiation of "organic" versus "developmental" factors as an area for further study.

Late neuropsychologic status after childhood head trauma

A neurologic and neuropsychologic test battery was administered to a sample of 35 children drawn from all those in a defined geographic area who had been hospitalized for head trauma before age 7 during the years 1970-1976. Examination was performed 3 1/2 to 10 years after injury, at age 6-15. Twelve subjects had been diagnosed at the time of injury as suffering moderate insult and had been referred to the metropolitan neurosurgical center, while twenty-three with only mild injury had been retained for observation in a local pediatric ward. The twelve with more severe insult were significantly inferior to the other subjects on the Block Design and Coding subtests of the revised Wechsler Intelligence Scale for Children. The Koppitz score of the Bender Test, the WISC-R scatter, the Benton Visual Retention Test, the GATB Motor Speed Test and the Bourdon-Wiersma Vigilance Test showed less diagnostic power and failed to distinguish between the group with more severe injury and that with less. A detailed and carefully scored neurologic examination also failed to distinguish between the two groups. The findings suggest that relatively common traumatic injury may be associated with detectable late cognitive deficit, and that some WISC-R subtests may be among the best measures for detecting such deficit.

Validity of Koppitz's developmental score as a measure of organicity

The Koppitz developmental score was used to evaluate the Bender Gestalt performances of 30 children with, and 30 children without, brain damage The brain-damaged children had a higher mean score than the non-brain-damaged Ss and did more poorly relative to the normative data reported by Koppitz.